The Anatomy of a Constructed Penis: What Phalloplasty Actually Creates
A phalloplasty-built organ is not a biological penis. It is a tube of skin—often taken from the arm or thigh—sewn into place and wrapped around the original clitoris. “It isn’t technically a penis at all, just a piece of skin covering a clitoris,” explains AdultHM source [citation:ecfb2efc-3305-4a3e-b427-5d432a5f2e57]. The new structure cannot lengthen or shorten on its own; instead, an internal pump must be hand-squeezed to force saline into rods that stiffen the skin tube. Urination is equally artificial: multiple detransitioners report “pee coming out of several holes along the length of the tube so there were 5 or 6 streams”—a scene goldenharedbrat calls “body horror” source [citation:666e496f-227a-42b5-915c-a79fdd4d44dc]. Sensation is often reduced or altered, and the graft site on the arm or leg is left with a large, permanent scar.

The Emotional Cost of Living with a Medical Construct
Because the organ does not behave like a natural penis, many experience daily reminders that their body has been surgically modified rather than “corrected.” nwtae sums up the psychological toll: “I am embarrassed and ashamed of what my genitals look like now and it has impacted my ability to have a normal, healthy romantic/sexual relationship” source [citation:60aee085-7240-464f-8032-1f244c780ca6]. Intimacy becomes mechanical—partners must wait while the device is pumped—and the fear of leaks or malfunctions can override desire. Over time, some feel their dysphoria has simply shifted from one body part to another.

Financial and Medical Risks
The procedure is expensive and rarely covered in full. nwtae paid “roughly $8k out of pocket” and still required additional surgeries for complications source [citation:60aee085-7240-464f-8032-1f244c780ca6]. Others report even graver outcomes: Lucretia123 mentions a trans man who “has had one leg amputated and has nerve damage” after phalloplasty source [citation:15c24443-ba93-4fb1-b0f8-b74ce9ade6f6]. Reversal is possible but complex; surgeons must re-route the urethra again and graft new tissue, with no guarantee of restored urinary or sexual function.

Reclaiming the Body Without Surgery
These stories reveal that altering anatomy does not necessarily ease distress; instead, it can introduce new sources of pain. Understanding that gender stereotypes—not bodies—create the feeling of “wrongness” opens space for non-medical healing: therapy focused on self-acceptance, community support that celebrates gender non-conformity, and creative expression that affirms the whole person. The path forward is not to carve the body into a new shape, but to free the mind from the belief that only one shape is allowed.